<div class="span10">
		  <div class="row-fluid">
			<div class="page-header">
				<h1><?=$titulo;?></h1>
			</div>
			<?php $atributos_formulario = array('id'=>'exm1','role'=>'form','onsubmit'=>'PreventMultipleSubmit()','class'=>'form-inline');
                            echo form_open ("clientecontroller/adicionarCliente",$atributos_formulario);
                            if(validation_errors())
                            {?>
                                <div class="alert alert-danger">
                                    <button type="button" class="close " data-dismiss="alert">&times;</button>
                                    <span><?=validation_errors();?></span>
                                </div>
                            <?php                            
                            }
                            
                             if($this->session->flashdata('cadastrook')){?>
                                <div class="alert alert-success">
                                    <button type="button" class="close " data-dismiss="alert">&times;</button>
                                    <p><?=$this->session->flashdata('cadastrook');?></p>
                                </div>
                             <?php
                            }?>
                   
                      <fieldset>
                          <div style="float: left; padding: 5px">
                                <h3>DADOS PESSOAIS</h3>
                              <hr />
					<div class="input-prepend">
                                <span class="add-on ticket">Nome</span>                                   
						
                                                    <?php echo form_input(array('name'=>'nome', 'id'=>'nome', 'type'=>'text','class'=>'input-xlarge form-control ','placeholder'=>'Nome Completo','required'=>'required'), mb_strtoupper(set_value('nome')));?>
                                                
                                                
                                        </div><br><br>
					 <div class="input-prepend">
                                <span class="add-on ticket">Dt.Nasc</span>
                                                
                                                   
                                                        <div id="datetimepicker" class="input-append date datetimepicker">
                                                              
                                                              <?php echo form_input(array('name'=>'dataNascimento', 'id'=>'dataNascimento', 'type'=>'text','class'=>'input-large inputData','placeholder'=>'Data de Nascimento','required'=>'required'), set_value('dataNascimento'));?>
                                                              <span class="add-on">
       								 <i data-time-icon="icon-time" data-date-icon="icon-calendar"></i>
                                                              </span>
   							</div>
                                                   
                                         </div><br><br>
                                  <div class="input-prepend">
                                <span class="add-on ticket">CPF</span>                                 
						
                                                    <?php echo form_input(array('name'=>'cpf', 'id'=>'cpf', 'type'=>'text','class'=>'input-xlarge form-control ','placeholder'=>'CPF'),set_value('cpf'));?>
                                              
                                                
                                  </div><br><br>
                                    <div class="input-prepend">
                                <span class="add-on ticket">RG</span>                                     
						
                                                    <?php echo form_input(array('name'=>'rg', 'id'=>'rg', 'type'=>'text','class'=>'input-xlarge form-control ','placeholder'=>'RG'),set_value('rg'));?>
                                                
                                                
                                    </div><br><br>
                                    <div class="input-prepend">
                                        <span class="add-on ticket">E.Civil</span>
                                                <?php
                                                    $config = 'class = "input-xlarge", required ="required"';
                                                    $options = array(
                                                    '' => 'Escolha uma opção',    
                                                    'CA'  => 'CASADO',
                                                    'SO'    => 'SOLTEIRO',
                                                    'SE'   => 'SEPARADO',
                                                    'DI' => 'DIVORCIADO',
                                                    'VI' => 'VIUVO',
                                                    'OU' => 'OUTROS',
                                                    );
                                                    echo form_dropdown('estadoCivil',$options,  set_value('estadoCivil'),$config);                                                     
                                                ?>
                                                
						 
                                    </div><br><br>
                                   
					                               
                          </div>
                           <div style="float: left; padding: 5px">
                               <h3>DADOS ENDEREÇO</h3>
                              <hr />
                              <div class="input-prepend cep-label">
                                <span class="add-on ticket">CEP</span>
                                   <?php echo form_input(array('name'=>'cep', 'id'=>'cep', 'type'=>'text','class'=>'input-xlarge form-control ','maxlength'=>'9','placeholder'=>'Informe o CEP'),set_value('cep'));?>
                                </div><br><br>

                            <div class="input-prepend">
                                <span class="add-on ticket">Rua</span>
                                <?php echo form_input(array('name'=>'rua', 'id'=>'rua', 'type'=>'text','class'=>'input-xlarge form-control ','placeholder'=>'Nome da Rua / Logradouro'),set_value('rua'));?>
                            </div><br><br>

                         

                            <div class="input-prepend">
                                <span class="add-on ticket">Bairro</span>
                                <?php echo form_input(array('name'=>'bairro', 'id'=>'bairro', 'type'=>'text','class'=>'input-xlarge form-control ','placeholder'=>'Informe Bairro'),set_value('bairro'));?>
                            </div><br><br>

                            <div class="input-prepend">
                                <span class="add-on ticket">Cidade</span>
                                <?php echo form_input(array('name'=>'cidade', 'id'=>'cidade', 'type'=>'text','class'=>'input-xlarge form-control ','placeholder'=>'Informe a Cidade'),set_value('cidade'));?>
                           </div><br><br>

                            <div class="input-prepend">
                                <span class="add-on ticket">UF</span>
                                <?php echo form_input(array('name'=>'uf', 'id'=>'uf', 'type'=>'text','class'=>'input-xlarge form-control ','placeholder'=>'Informe o UF'),set_value('uf'));?>
                           </div><br><br>
                           
                           <div class="input-prepend">
                                <span class="add-on ticket">Telefone</span>
                                <?php echo form_input(array('name'=>'telefone', 'id'=>'telefone', 'type'=>'text','class'=>'input-xlarge form-control inputTelefone','placeholder'=>'Informe o telefone','required'=>'required'),set_value('telefone'));?>
                           </div>

                           </div>
                         
                                  
                         
                          <div style="float: left; padding: 5px">
                               <h3>DADOS COMERCIAIS</h3>
                              <hr />
                              <div class="input-prepend">
                                        <span class="add-on ticket">Profis</span>
                                        <?php echo form_input(array('name'=>'profissao', 'id'=>'profissao', 'type'=>'text','class'=>'input-xlarge form-control','placeholder'=>'Informe a profissão'),set_value('profissao'));?>
                                </div><br><br>


                                <!-- Text input-->
                                <div class="input-prepend">
                                       <span class="add-on ticket">Renda</span>
                                       <?php echo form_input(array('name'=>'renda', 'id'=>'renda', 'type'=>'text','class'=>'input-xlarge form-control moeda','placeholder'=>'Informe a renda'),set_value('renda'));?>
                                </div><br><br>
                                <!-- Text input-->
                                <div class="input-prepend">
                                    <span class="add-on ticket">E.Com</span>
                                    <?php echo form_input(array('name'=>'enderecoComercial', 'id'=>'enderecoComercial', 'type'=>'text','class'=>'input-xlarge form-control','placeholder'=>'Endereço Comercial'),set_value('enderecoComercial'));?>
                                </div><br><br><!-- Text input-->
                                
                                <div class="input-prepend">
                                    <span class="add-on ticket">Telefone</span>
                                    <?php echo form_input(array('name'=>'telefoneComercial', 'id'=>'telefoneComercial', 'type'=>'text','class'=>'input-xlarge form-control inputTelefone','placeholder'=>'Informe o telefone comercial','required'=>'required'),set_value('telefoneComercial'));?>                                   
                                </div><br><br>
                                
                                <div class="input-prepend">
                                    <span class="add-on ticket">P. Resp</span>
                                    <?php echo form_input(array('name'=>'profissaoResponsavel', 'id'=>'profissaoResponsavel', 'type'=>'text','class'=>'input-xlarge form-control','placeholder'=>'Profissão Responsável'),set_value('profissaoResponsavel'));?>
                                </div><br><br>
                                
                                <div class="input-prepend">
                                    <span class="add-on ticket">Indicado</span>
                                    <?php echo form_input(array('name'=>'indicacaoTratamento', 'id'=>'indicacaoTratamento', 'type'=>'text','class'=>'input-xlarge form-control','placeholder'=>'Indicado por'),set_value('indicacaoTratamento'));?>
                                </div><br><br>
                                
                                <!-- Text input-->
                                <div class="input-prepend">
                                    <span class="add-on ticket">I. Trat</span>
                                    <div id="datetimepicker" class="input-append date datetimepicker">
                                    <?php echo form_input(array('name'=>'dataInicioTratamento', 'id'=>'dataInicioTratamento', 'type'=>'text','class'=>'input-large inputData','placeholder'=>'Data Início Tratamento'), mb_strtoupper(set_value('dataInicioTratamento')));?>
                                      <span class="add-on">
       					 <i data-time-icon="icon-time" data-date-icon="icon-calendar"></i>
                                     </span>
                                    </div>
                                </div>
                          </div>
                          
                          <br clear="all" />
					<div class="form-actions">
						<input type="submit" class="btn btn-success btn-large" value="Salvar" /> 
                                                <?=anchor(base_url()."principalcontroller","Cancelar",array('class'=>'btn'));?>                                                
					</div>					
				</fieldset>
			</form>
		  </div>
        </div>